Jennifer R Selle, RNC CADC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

0041-213915 Issued in IL

Practice address

37444 N Delany Rd
Gurnee, IL 60031-3525

Phone

(847) 249-4776

Fax

(847) 249-7497

NPI assigned

Feb 22, 2012

Last updated

Feb 22, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1427321306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37444 N DELANY RD",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313525",
            "telephone_number": "847-249-4776",
            "fax_number": "847-249-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37444 N DELANY RD",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313525",
            "telephone_number": "847-249-4776",
            "fax_number": "847-249-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLE",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "RNC CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "0041-213915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.